scholarly journals Trends in Pediatric Palliative Care Research (TPPCR) 2021; Issue #3: Commentary on Guttmann et al and Dryden-Palmer et al.

2021 ◽  
Author(s):  
Christina Vadeboncoeur ◽  
TPPCR
Keyword(s):  
Intensive Care Unit ◽  
Palliative Care ◽  
Critical Care ◽  
Intensive Care ◽  
Symptom Management ◽  
Neonatal Intensive Care ◽  
Moral Distress ◽  
Pediatric Palliative Care ◽  
Pediatric Critical Care ◽  
Intensive Care Unit Staff

This TPPCR commentary discusses the 2021 paper by Guttmann et al and Dryden-Palmer et al., “Goals of Care Discussions and Moral Distress among Neonatal Intensive Care Unit Staff” published in the Journal of Pain and Symptom Management and the 2021 paper by Dryden-Palmer et al., “Moral Distress of Clinicians in Canadian Pediatric and Neonatal ICUs” published in Pediatric Critical Care Medicine.

Response to “Giving ‘Moral Distress’ a Voice: Ethical Concerns Among Neonatal Intensive Care Unit Personnel” by Pam Hefferman and Steve Heilig and “Neonatal Viability in the 1990s: Held Hostage by Technology” by Jonathan Muraskas et al. (CQ Vol 8, No 2)

2000 ◽  
Vol 9 (3) ◽  
pp. 400-403 ◽  
Author(s):  
Anita J. Catlin ◽  
Brian S. Carter
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Moral Distress ◽  
Medical Support ◽  
Ethical Concerns ◽  
Growing Body ◽  
Care Practices

The Spring 1999 issue of Cambridge Quarterly (Volume 8, Number 2) adds to the growing body of academic inquiry into the goals of neonatal intensive care practices. Muraskas and colleagues thoughtfully presented the possibility of nontreatment for neonates born at or under 24 weeks gestation. Jain, Thomasma, and Ragas explained that quality of future life must not be ignored in clinical deliberation. And Hefferman and Heilig described once again the dilemmas nurses face when caring for potentially devastated neonates kept alive by technology. These authors take brave steps by publicly questioning the trend of intensive medical support for most every American-born product of conception. But many questions addressing the goals of neonatal intensive care remain, and few authors have actually tried to distill these goals.

scholarly journals Is there a role of palliative care in the neonatal intensive care unit in India?

2011 ◽  
Vol 17 (2) ◽  
pp. 104 ◽  
Author(s):  
ManjiriP Dighe ◽  
SwatiA Manerkar ◽  
MaryannA Muckaden ◽  
BalajiP Duraisamy
Keyword(s):  
Intensive Care Unit ◽  
Palliative Care ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care

scholarly journals Relationships Among Palliative Care, Ethical Climate, Empowerment, and Moral Distress in Intensive Care Unit Nurses

2018 ◽  
Vol 27 (4) ◽  
pp. 295-302 ◽  
Author(s):  
Krista Wolcott Altaker ◽  
Jill Howie-Esquivel ◽  
Janine K. Cataldo
Keyword(s):  
Intensive Care Unit ◽  
Palliative Care ◽  
Intensive Care ◽  
Ethical Climate ◽  
Moral Distress ◽  
Care Delivery ◽  
National Database ◽  
Palliative Care Teams ◽  
Intensive Care Unit Nurses ◽  
Distress Scale

Background Intensive care unit nurses experience moral distress when they feel unable to deliver ethically appropriate care to patients. Moral distress is associated with nurse burnout and patient care avoidance. Objectives To evaluate relationships among moral distress, empowerment, ethical climate, and access to palliative care in the intensive care unit. Methods Intensive care unit nurses in a national database were recruited to complete an online survey based on the Moral Distress Scale–Revised, Psychological Empowerment Index, Hospital Ethical Climate Survey, and a palliative care delivery questionnaire. Descriptive, correlational, and regression analyses were performed. Results Of 288 initiated surveys, 238 were completed. Participants were nationally representative of nurses by age, years of experience, and geographical region. Most were white and female and had a bachelor’s degree. The mean moral distress score was moderately high, and correlations were found with empowerment (r = −0.145; P = .02) and ethical climate scores (r = −0.354; P < .001). Relationships between moral distress and empowerment scores and between moral distress and ethical climate scores were not affected by access to palliative care. Nurses reporting palliative care access had higher moral distress scores than those without such access. Education, ethnicity, unit size, access to full palliative care team, and ethical climate explained variance in moral distress scores. Conclusions Poor ethical climate, unintegrated palliative care teams, and nurse empowerment are associated with increased moral distress. The findings highlight the need to promote palliative care education and palliative care teams that are well integrated into intensive care units.

Moral Distress of Staff Nurses in a Medical Intensive Care Unit

2005 ◽  
Vol 14 (6) ◽  
pp. 523-530 ◽  
Author(s):  
Ellen H. Elpern ◽  
Barbara Covert ◽  
Ruth Kleinpell
Keyword(s):  
Job Satisfaction ◽  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Moral Distress ◽  
Medical Intensive Care Unit ◽  
Well Being ◽  
Individual Characteristics ◽  
Medical Intensive Care ◽  
Distress Scale

• Background Moral distress is caused by situations in which the ethically appropriate course of action is known but cannot be taken. Moral distress is thought to be a serious problem among nurses, particularly those who practice in critical care. It has been associated with job dissatisfaction and loss of nurses from the workplace and the profession.• Objectives To assess the level of moral distress of nurses in a medical intensive care unit, identify situations that result in high levels of moral distress, explore implications of moral distress, and evaluate associations among moral distress and individual characteristics of nurses.• Methods A descriptive, questionnaire study was used. A total of 28 nurses working in a medical intensive care unit anonymously completed a 38-item moral distress scale and described implications of experiences of moral distress.• Results Nurses reported a moderate level of moral distress overall. Highest levels of distress were associated with the provision of aggressive care to patients not expected to benefit from that care. Moral distress was significantly correlated with years of nursing experience. Nurses reported that moral distress adversely affected job satisfaction, retention, psychological and physical well-being, self-image, and spirituality. Experience of moral distress also influenced attitudes toward advance directives and participation in blood donation and organ donation.• Conclusions Critical care nurses commonly encounter situations that are associated with high levels of moral distress. Experiences of moral distress have implications that extend well beyond job satisfaction and retention. Strategies to mitigate moral distress should be developed and tested.

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